Caninsulin
CaninsulinCaninsulin-Pharmacokinetics, manufactured by Intervet and known in some countries as VetsulinVetsulin Website, is a veterinary porcine lente insulin, made up of 30% semilente (short-acting) and 70% ultralente (long acting) insulins. It is a suspension of crystalline (ultralente) and amorphous (semilente) insulins in the ratio shown above, as are all Lente insulinsEMEA Scientific Discussion Monotard . At present in the US, Caninsulin is FDA-approved for use only in dogs under the trade name Vetsulin. However, it is often used in the US "off label" for cats too. According to US law, any drug--whether it is approved for humans or animals--may be legally used in treatment(s) other than those which the drug received its approval(s) for. Everyone using non-veterinary insulins in the US for their pets is technically using them legally off-label. How it works in dogs The majority of dogs on Caninsulin/Vetsulin (two-thirds) also will require twice-dailyVetsulin Insulin RequirementsCaninsulin-Twice Daily Regimen for Dogs & Cats (Page 6) injections. Intervet says that many dogs stabilize better on twice-daily insulin injections. They also point out that when shots are given twice instead of once daily, there are less hyperglycemia incidents and better blood glucose controlCaninsulin-Starting Insulin in the Healthy Diabetic Patient (Page 4). Caninsulin/Vetsulin is a lente insulin, which is classed as intermediate, not long acting. Long acting insulins (such as Lantus,ACVIM 2004 Abstract #226-Lantus Inconsistent in Dogs-Fleeman & Rand-Comparison of Pharmacodynamics & Pharmacokinetics of Glargine (Lantus), Protamine Zinc (PZI) & Pork Lente in Dogs Ultralente, PZI) have a poor success rate among dogs. For those with dogs, here is a graph of the canine activity. http://www.caninsulin.com/images/insulinactivitydog.jpg How it works in cats Caninsulin is intended for dogs, but works (somewhat differently) in cats too. Note that feline usage is "off-label" in the US. Caninsulin is a BID (two times a day) insulin in catsCaninsulin-Twice Daily Regimen in Dogs and Cats (Page 6), dute to the faster metabolism of the catCaninsulin-Starting Insulin Therapy in the Healthy Diabetic Patient (Page 4). The fast drop experienced by cats is a drawback. (Note the glucose drop from 25.0mmol (450mg) to about 7.5 (135mg) in just four hours, advertised by the manufacturer as typical in cats.) Because of the harshness of that initial drop, it may be important in cats to time shots together with meals. http://www.caninsulin.com/images/insulinactivitycat.jpg Some cats can have good results with Caninsulin despite this drawback, or even make good use of it, as shown in the case of Butterscotch. Technical details Caninsulin is an aqueous suspension of insulin containing 40 IU per ml of highly purified porcine insulin (Lente); 30% is amorphousMerck Manual Amorphous Definition (non-crystallized) zinc (Semilente) insulin and 70% crystalline (in crystal form) zinc (Ultralente) insulin. The difference between Caninsulin and both Iletin II LenteIletin II Lente-Lente Pork Insulin Remedyfind.com made by Eli Lilly and Monotard PorkEvaluation of an Insulin Zinc Suspension for Control of naturally Occurring Diabetes Mellitus in Dogs-Australian Veterinary Journal-2000 (Page 3) made by Novo Nordisk is this: Caninsulin/Vetsulin is a veterinary insulin of U40 strength. Both Novo's and Lilly's insulins were U100 strength. No Lente-type insulin regardless of species can contain any NPH/isophane insulinCombining Lente-type Insulins with Phenol-Preserved Insulins or any R/Neutral insulinLente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect. Both are chemically impossible: the phenol preservative present in NPH/isophane alters the action of Lente-type insulins, creating a mixture with an approximate action of R/Neutral. The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effectIntermediate-Acting Insulin Preparations: NPH (Isophane) & Lente Diabetes Care-1980 Note--in 1980, there was only beef Lente-type insulin--no pork or r-DNA/GE/GMLente insulins. Caninsulin contains porcine insulin. Porcine insulin is identical to canine insulinIntervet-Caninsulin-Product Information, but differs from human insulin in respect of one key amino acid. Porcine insulin differs from feline insulin in 3 amino acid positions shown in the table belowAmino Acid Sequences. Insulin Amino Acid Differences How to get it It is a prescribed insulin, for veterinary use. A human pharmacy will not have it, and you must get a prescription. It is available online1800 PetMeds Website in some countries, and may cost less that way. Available in 2.5ml and 10 ml vials. Cats and and small dogs can get new vials monthly without wasting. Because Caninsulin is is a U40 insulin, U40 syringes are the most helpful. If you choose to use a U100 syringe, you must do the U40 to U100 conversionFDMB-Using U40 Insulin in a U100 Syringe. The conversion is not difficult and can give you precision of 0.2 units for those animals needing a more precise dose. Special Syringes: Good or bad? Personal note: I used a human U100 syringe when I ran out of the Caninsulin syringes and my cat Butterscotch stared at me in shock with wide eyes! The Caninsulin syringes are not only thin but seem to be made in such a way that pets don't notice it--one person's experience with one cat: probably not really a "most cats" thing at all. In general you will find that "most cats" are amazingly tolerant of any shot or needle, whereas mine did notice the U100 syringe. No idea why, perhaps the slope...The Caninsulin U40 syringe is very small. Another user's personal note: My little Max (all whopping 7 pds of world-traveling, "he-man" poodle-extraordinare) is usually not adverse to needles (he handles the fructosomine and BG curves at the Vet with flying colors, nary a peep out of him). But, when it came to using the U-40 syringe, whether administered by the Vet or myself, it was a complete 180-degree reversal. After speaking at length with Vets treating Max, we felt the best approach was to switch to the BD Ultra 100 syringe with the 31 gauge needle. Granted, you have to do the math, a x2.5 conversion of dosage for the U-40 to U-100 switch, but I can tell you if you have a problematic pet when it comes to using the U-40, the extra money these syringes cost is well worth the lessening of aggravation to both owner and pet. Picture of the caninsulin syringe:Caninsulin Syringe Photo Further Reading * Caninsulin web site * Vetsulin web site * Buy vetsulin online, perhaps cheaper than at your vet *PetPharm offers Caninsulin as an over the counter (OTC) medication. Their policy is to ship insulin within Canada only with deliveries made by courier. *Best Pet Pharmacy is online and UK-based, serving the UK and Northern Ireland only. As of October 31, 2005, UK law abolished all charges vets could make for writing prescriptions so one could possibly obtain medications cheaper elsewhere. All insulins in the UK are considered POM--prescription-only medications. Abolition of the fees for writing prescriptions makes it possible to obtain one and then shop with them online. *Horn-Mitten study from Australian Veterinary Journal, citing Church's study equating Caninsulin with Monotard Pork, thus the need for two shots a day in dogs. *Australian Veterinary Journal-Drs. Horn & Mitten Respond to Caninsulin Once-Daily Dosing Claims for Dogs *Use in rabbits Though not licensed/approved for use in rabbits, Intervet presents some helpful information on using Caninsulin/Vetsulin for them. *Click Here For Photo of Caninsulin Syringe With Magnifier *Pharmacology of a U40 Porcine Lente Insulin Preparation in Diabetic Cats--Journal of Feline Medicine & Surgery-Rand & Martin-2001 *Efficacy & Safety of a Purified Porcine Insulin Zinc Suspension for Managing Diabetes Mellitus in Dogs-JAVMA-Dr. Laxton, et. al.-2005 References Category:InsulinsCategory:intermediate-actingCategory:Lente Category:VeterinaryCategory:porcine